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A rural emergency medical retrieval service: the first year

¹ Emergency Medicine, Royal Alexandra Hospital, Paisley, PA2 9PN, UK
² Emergency Medicine and Retrieval Medicine, Royal Alexandra Hospital, Paisley, PA2 9PN, UK
³ Anaesthesia and Intensive Care, Southern General Hospital, Glasgow, G51 4TF, UK
⁴ Emergency Medicine, Royal Alexandra Hospital, Paisley, PA2 9PN, UK

Correspondence to:
Correspondence to:
Dr Alasdair R Corfield
Emergency Medicine, Royal Alexandra Hospital, Paisley, PA2 9PN, UK; alasdair.corfield{at}rah.scot.nhs.uk

Introduction: We describe the first year of operation of a rural emergency medical retrieval service (EMRS), staffed by emergency medicine and anaesthetic consultants and providing air based retrieval of critically ill and injured patients from general practitioner led community hospitals in rural west Scotland.

Methods: Data were collected on all patients referred to the service, both those subsequently transported and those where transport by the service was not indicated, for a period of 1 year from 1 October 2004 to 30 September 2005. Data collected included information on demographics, physiology, and medical interventions. Detailed data were collected regarding advanced airway care and any complications relating to transfer.

Results: Forty patients were attended and advice was given on a further 21 patients. Twenty one of the 40 patients (53%) required rapid sequence intubation prior to transfer. The median Injury Severity Score (ISS) for trauma patients was 26 (range 2–59). The median Acute Physiology and Chronic Health Evaluation (APACHE) II score for all patients was 11 (range 2–37).

Conclusion: Our data show a high level of acuity among this patient group and a need for advanced medical intervention to ensure safe transfer.

Abbreviations: APACHE, Acute Physiology and Chronic Health Evaluation; EMRS, emergency medical retrieval service; ISS, Injury Severity Score; SAPS, Simplified Acute Physiology Score; SAS, Scottish Ambulance Service; RSI, rapid sequence intubation; TISS, Therapeutic Intervention Scoring System

Keywords: aeromedical; critical care; emergency medicine; retrieval; transfer

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